Your Tendon Injury Does Not Need to Be Stretched!

“What stretches can I do for my tendon injury?” is a common question that we get asked at the clinic. Often with soft tissue injuries (muscle, ligament, tendon), clients try stretching as a home remedy to expedite their recovery and minimize discomfort. From the research and clinical experience, static stretching does not improve the health of the tissue and can in fact make it worse.

Let’s look at tendon injuries and why they may respond unfavourably to static stretching.

What is a tendon?

A tendon is the tissue which connects a muscle to the bone. The tendon functions as a way of absorbing force and distributing force between the muscle and bone. At a microscopic level, tendons appear similar to fiberoptic cables, where small bundles of collagen are grouped together.

What is tendinopathy?

Tendinopathy is the broad term for a problem with the tendon. It often presents at a time when the body has changed load and the capacity of the tendon has not appropriately adapted to this change. For example, Achilles tendinopathy may start when a casual runner starts to implement 2 additional sessions of hill sprint running into their weekly regime. It can sometimes be as innocuous as a person who is returning to activity after a 3-week holiday. In essence, tendon injuries arise when the load exceeds the capacity of the tendon.

A typical tendon presentation of a tendinopathy includes:

·       Localised pain over the tendon

·       Worse on increased loading tests, particularly as you add more plyometric force

·       Morning stiffness/pain, particularly the day after an aggravating activity

·       Change in loading patterns

·       Symptoms occur at the start of activity and then warm up

It is important to note that tendons are aggravated by two things: compression and tensile load.

Compression refers often to the compression of the tendon on a bony area or external pressure on the tendon (e.g. physically pressing on the tendon). A common example of this is in high hamstring tendinopathies where sitting compresses the tendon against the sit bone or ischial tuberosity.

Tensile load refers to the force or stress placed on a tendon when a muscle contraction occurs.

So, why is static stretching not ideal for my tendon?

Static stretching is not recommended for tendinopathies as they can increase compression and increase stress on the already-injured tendon. There is early evidence that it can disrupt tendon healing, and furthermore, there is a lack of evidence that shows any benefit of static strengthening on the functional improvement of tendinopathies.

What exercises can benefit my tendon?

·       Heavy isometric exercises have been shown to reduce pain levels in the acute stages of tendinopathy

·       Slow, eccentric strength exercises also promote collagen repair and structure, as well as providing analgesic effects

·       Steer away from exercises that increase the compression on the tendon or plyometric exercises as this can aggravate the tendons.

So, next time you come across a tendon injury, think twice before you try statically stretching the tendon!

Credit Image: https://www.britannica.com/science/tendon